Alzheimer’s and Dressing

(Alzheimer’s Society) The way we dress says a lot about who we are. For most of us, dressing is a very personal and private activity – and one where we are used to making our own decisions. As dementiaprogresses, people increasingly need more help with everyday activities, including dressing. It is important to enable a person withdementiato make their own choices for as long as they can and, if they do need assistance, to offer it tactfully and sensitively.

This factsheet for carers contains tips for helping a person with dementia to dress and advice on how to make dressing a positive experience for them and for you.

Tips for helping a person with dementia to dress

Helping someone with dementia choose what to wear is an important role. You will be helping them to retain some choice and to express their own identity and personal style. You will also be helping to make sure that they are clean, warm and comfortable. Here are some tips.

Give the person choice

Wherever possible, ask the person what they would like to put on. Someone with dementia needs the dignity of having a choice in what they wear, but too many options can be confusing, so it may be best to make suggestions one at a time or offer them the choice of only two options.

If the person has lots of clothes, put the things they wear most frequently somewhere accessible. This will make it easier for them to choose.

Encourage independence

Lay out clothes on a non-patterned background in the order the person will put them on (starting with underwear and ending with a cardigan or jumper). If they require help, remind them sensitively which garment comes next or hand them the item that they need.

Make sure that items are not inside out and that buttons, zips and fasteners are all undone.

If the person is confused, give instructions in very small steps, such as, ‘Now put your arm through the sleeve’. It may help to use gestures to demonstrate these instructions.

If mistakes are made – for example, by putting something on the wrong way round – be tactful, or find a way for you both to laugh about it.

Place labels on drawers where particular items of clothing are kept, or store whole outfits together. If using labels, a combination of pictures and words may be understood better than words alone.

Help the person stay comfortable

Make sure the room is warm enough to get dressed in.

Ensure that the lighting levels are suitable.

Provide a suitable chair with arms if the person has poor balance.

Think about privacy – make sure that blinds or curtains are closed and that no one will walk in and disturb the person while they are dressing.

Ask the person if they would like to go to the toilet before getting dressed.

Try to keep to the person’s preferred routine – for example, they may like to put on all their underwear and socks before putting on anything else.

It can be useful if the person wears several thin layers of clothing, particularly in cold weather, rather than one thick layer, as they can then remove a layer if it gets too warm.

Remember that the person may no longer be able to tell you if they are too hot or cold, so keep an eye out for signs of discomfort.

Change clothes regularly

Sometimes people with dementia are reluctant to undress, even when they go to bed, or will refuse to change their clothes. It’s important to make sure the person changes their clothes every day, and to find ways to do this without upsetting them. Here are a few ways you could persuade someone:

Remove dirty clothing and put clean clothing in its place when the person is in the bath or shower, or when they go to bed.

Encourage them to change for certain occasions, for example because someone is coming to visit, or they are due to go to a formal group event.

Tell them how much you’d love to see them wearing something new.

Go clothes shopping together

If you’re buying clothes for the person with dementia, try to take them with you, so that they can choose the style and colours they prefer.

Shop in places that are familiar to the person and which match their style and preferences. If shop staff know the person they should be able to help make the experience more enjoyable. Remember that large, busy shops with lots of choice may feel overwhelming.

Check the person’s size before buying. They may have lost or gained weight without you realising.
Order clothes from catalogues or online, or buy from shops that accept returns. You can then offer choice and the person with dementia can try the clothes at home without the stress of a visit to the shops.

If the person with dementia will need help trying on clothes, bear in mind that shops may not allow men into the ladies’ fitting room (and vice versa).

Look for clothes that are machine washable and need little ironing, as this will save time.

The person with dementia may not recognise new clothes as belonging to them if they have no memory of having bought them, and so may not want to wear them. It may be better to buy more of the clothes that the person likes and is familiar with, rather than something different.

Accept any unusual clothing choices

It is important to respect the person’s choice of what to wear. As long as it does no harm, it’s better to accept the person dressing in an unusual way, or wearing clothing that is out of place, than to have a confrontation. If the person is determined to wear a hat in bed, for example, or a heavy coat in summer, try to respect their choice, unless it might cause harm.

If the person’s clothing choices are causing a problem (such as a long dress or coat that may cause someone to trip and fall), you may want to consider putting away inappropriate items so that the person is not tempted to wear them. For more information seefactsheet 525, Changes in behaviour.

Making dressing a positive experience

Helping a person to look the way they want is an important way of maintaining their confidence. Compliment them on the way they look and encourage them to take pride in their appearance.

Allow enough time

If you are helping someone with dementia to dress, allow plenty of time so that neither of you feels rushed. They may take longer to process information than they used to and this may affect their ability to make choices. If you can make dressing an enjoyable activity, the person will feel more relaxed and confident.

Try to use the time to chat about what you are doing and anything else that might be of interest.

If the person resists your efforts to help, try leaving them for a while. They may be more willing to co-operate if you try again a little later.

Other aspects of grooming

Remember that if the person with dementia has been used to wearing make-up, hair products or jewellery, and wants to continue doing so, they may need help to put it on. Similarly they may like to continue using aftershave or perfume.

It is really important to be aware of what the person with dementia usually likes and not to make assumptions about how they would like to look. Photographs are a good way of remembering how the person likes to wear their hair, make-up or accessories. You could also photograph complete outfits to give the person a prompt of what goes with what.

The person might be used to going to the beauty salon or hairdressers and may want to continue to do this. Some people may prefer to have a hairdresser come to their house.

Practical ideas for what to wear

People with dementia may have difficulties dressing. It may help to look for clothes that are easy to put on and take off, such as clothes with larger neck openings, front fastenings or no fastenings – or to make some adaptations to the clothes they already have.

If someone is not enjoying wearing something – perhaps because it is physically uncomfortable, they are sensitive to certain textures, they don’t like it or it is new and seems unfamiliar – it may cause them distress and discomfort.

The following tips may be useful in helping a person choose what to wear.

Use Velcro fastenings or poppers rather than buttons.

Shoes with laces may be difficult for someone with dementia to manage. Try well-fitting slip-on shoes or shoes with Velcro fastenings, or replace shoelaces with elastic.

The person shouldn’t wear slippers for more than a few hours, as they may not offer enough support to the feet.

For women, going without a bra may be uncomfortable. Some women may find it easier to manage a front-opening bra. Try to avoid self-supporting stockings, as they can cause circulation problems.
For men, boxer shorts are usually easier to manage than Y-fronts.

Remember that the way a person with dementia looks will help them to understand what they are doing.

For example, if they are dressed for work they may think they need to go to work. If they are dressed in clothing they usually relax in, this will remind them that they are not at work. Similarly, wearing nightwear during the day may make the person think that it is time for bed.